I have been seeing commercials for cord blood banking for a long time. Today, I saw a new commercial for the first time. In it, a woman claims that her son was “cured of sickle cell” using cord blood.
Um… wha? Isn’t sickle cell genetic and chronic? Even if the cord blood provided a treatment option, doesn’t it eventually run out?
What’s going on?
I did some googling of “bone marrow treatment sickle cell” and found quite a few hits, including some from the FDA.
The theory is probably that you’re replacing the “bad-cell-producing” bone marrow with “good-cell-producing” marrow. So the recipient now has healthy cells being generated in his body, and no longer suffers from the sickle-cell flareups.
Cord blood can be used instead of bone marrow for a number of applications, including (apparently) sickle cell disease. The advantage is that it doesn’t have to be as closely matched as marrow does (and perhaps there may be fewer problems with rejection in general?). One disadvantage I know of is that there simply isn’t enough quantity in a cord to help a larger person, so it’s more commonly used for a child.
Yes, the sickle cell trait is still there. A child who was “cured” of the illness could grow up to father a child who was a carrier (or even had the disease). But the cure-ee wouldn’t himself experience the sickle-cell crises.
I’d like to see some links on this if you don’t mind, because on the surface of it, this just doesn’t make sense. Cord blood comes from the fetus, so if the child has sickle-cell anemia, the cord blood will still have the mutation and continue to make “bad” cells. It’d be like taking bone marrow from the thigh and moving it to the hip and expecting it to behave differently. Unless they’re treating the cord blood in some way that hasn’t been mentioned…
Now, if they’re using cord blood from a different person, well, that’s a whole different story. But in that case, I don’t know what the advantage would be in using cord blood rather than just a run of the mill bone marrow transplant.
That’s what they’re doing. Taking cord cells from a non-HbS (HbS = hemoglobin that “sickles”) baby and transplanting them in a person who has the genes for HbS, but who will now produce Hb-non-S because of the transplant. IIRC from my biochem exam from a few weeks ago, the recipient may still produce some HbS, but the red cells containing that HbS will so few in number compared to transplanted red cell producers that the recipient will not suffer from SS crises. There are also rare individuals with SSA, but they also make HbF, fetal hemoglobin that stops the sickling before it goes too far.
The advantage to using fetal cord cells as opposed to an adult donor is that you don’t have to worry about as much about matching donor to recipient. Fetal cells are flexible enough not to cause the same kind of immune system reaction problems that adult bone marrow cells could create.
Vlad/Igor
What Vlad/Igor said. I just went to a lecture two weeks ago where the speaker was a hematologist discussing current Sickle therapy.
BMT with cord stem cells is being widely studied, not just for Sickle-S, but also Sickle-C, and the various Sickle-thal entities.
So far, it’s a treatment that has been shown to be effective in some kids, the younger the better. It’s not a treatment for older kids or adults with the sickling hemoglobinopathies.
Ah, well, that makes sense then. Groovy.
Don’t they have to irradiate (kill) the bad cells first?
Yep. From here,
The Mayo site I’ve quoted is dealing (I think)( with marrow transplants for cancer (hence the mention of radiation possibly done after the transplant).
Here’s another link that specifically discusses transplants for sickle cell treatment: http://www.scinfo.org/bonemarr.htm
Wow. That’s really cool.
Are there any risks to using cord blood from a different person? Any above and beyond the blood-type compatability issue?